Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SAMANTHA JO DATES
ActiveSAMANTHA JO DATES is a Licensed Practical Nurse healthcare provider located in RANDOLPH, Wisconsin. NPI 1538767355 is currently active in the NPPES registry. Verify at CMS.
Licensed Practical Nurse · RANDOLPH, WI
Registration Details
- NPI Number
- 1538767355
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 14, 2020 (5.8565838423029 yrs)
- Last Updated
- Oct 14, 2020
- License
-
325608 (WI)
Practice Information
- Address
-
N8273 E FRIESLAND RDRANDOLPH, WI, 539569407Browse WI providers · Browse ZIP 53956
- Phone
- 9202967067
- Primary Specialty
-
Licensed Practical Nurse
164W00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.